A 59-year-old man with persistent fever, aphasia and leg pain

Labbe et al examine the case of a 59-year-old man with peripheral mycotic aneurysm adjacent to the deep vein thrombosis (DVT). The patient's enterococcal endocarditis began insidiously. His leukocyte count was within the reference range, as was found in 53% of patients in a retrospective cohort study. The patient's fibular aneurysm was caused by a septic embolus that created a focus of infection in the fibular artery wall, and it is possible that a small mycotic aneurysm was missed by the first ultrasonography. The local infection and inflammation may have caused a DVT in the contiguous posterior tibial vein. Compression by the growing mycotic aneurysm could explain the persistence of the DVT despite anticoagulation treatment.